HEALTH EXP ERIENCES OF SEXUAL AND GENDER MINORITY PEOPLE LIVING WITH DEMENTIA AND THEIR CAREGIVERS: A SCOPING REVIEW

Abstract People living with dementia and older adults who identify as sexual and gender minority (SGM - lesbian, gay, bisexual, transgender, queer individuals) both represent minoritized groups of older adults, but little is known about the health experiences of older adults who are at the intersection of having dementia and also identify as SGM. This review explored the extent and nature of research focused on health and healthcare experiences of SGM people with dementia and/or their informal caregivers. A scoping review framework was used given the exploratory nature of the project’s purpose. Health librarians comprehensively searched four databases (MEDLINE, CINAHL, PsycINFO, AgeLine) to identify relevant studies. A total of 8,137 unique titles and abstracts were reviewed by 2 independent reviewers. Forty citations were determined relevant and reviewed by full text. Eight studies met inclusion criteria and were analyzed thematically. Study methods were quantitative cross-sectional (n=2), qualitative exploratory (n=4), and a mixed methods case study (n=1). Studies were published from 2010–2022. Sample sizes ranged from 1 to 415 (M=113, SD=116). Four studies focused on caregivers, 2 on persons with dementia, and 1 on dyads. Themes emerged pertaining to caregiver health and well-being, identity, relationships, disclosure, discrimination, and safety. Findings highlight the significance of inclusive care that addresses intersecting psychosocial and health-related identities (e.g., cognitive status, SGM status, race/ethnicity, substance abuse history, multimorbidity) and that protects the rights of families of choice. More research is needed to better understand how sociopolitical structure influences dynamics between cognitive health and SGM status among older adults.

programs address ADRD internationally, we examined LTCH quality measures in four European countries-The Netherlands, Switzerland, Germany, and Belgium-following procedures previously used to examine international LTCH quality assurance measures. 73 measures were examined across 4 quality assurance programs. 26% of the measures addressed ADRD. The programs addressed ADRD in starkly different ways: in The Netherlands and Belgium no measures addressed ADRD; in Germany the majority (13/15) of measures addressed ADRD as an exclusion or inclusion criterion; and in Switzerland all the measures addressed ADRD through risk adjustment. Although limited to examining measures from LTCH quality assurance programs in four European countries, this study adds evidence that ADRD tends not to be addressed by LTCH quality measures, but when ADRD is addressed, it tends to be through risk adjustment. LTCH regulators, policymakers, and providers can use this information to assess options for addressing ADRD in quality assurance programs. Future research is needed to assess how standard indicators of quality differ across quality assurance regimes and how to address dementia beyond risk adjustment.

INCORPORATING SPIRITUALITY INTO COGNITIVE STIMULATION THERAPY GROUPS FOR PERSONS WITH DEMENTIA
Ebow Nketsiah, 1 Max Zubatsky, 1 and Marla Berg-Weger 2 , 1. Saint Louis University,St. Louis,Missouri,United States,MO,Saint Louis,Missouri,United States With the rise in Dementia-Related Disorders globally, few non-pharmacological approaches have been developed to effectively target cognitive impairment and memory loss. Cognitive Stimulation Therapy (CST) has shown effectiveness in improving cognition and quality of life of older adults with dementia. To date, no studies have incorporated spirituality into CST for improving the cognition and quality of life of older adults with dementia. This study's aim is to evaluate the effectiveness of CST with a spirituality component compared to the traditional CST group intervention. Our team grouped participants (Nf34) into either spiritual or traditional groups based on their location of residence and level of cognition. Preliminary results showed that spiritual-themed groups improved in mental health status, mobility, and depression. The spiritual groups had a mean difference of 1.85-points improvement on mental status exam as compared to 0.2-point reduction for the traditional groups. In addition, the spiritual groups had a mean difference of 4.80-points improvement in mobility and 0.6-point improvement on depression as compared to a 5.25-points reduction in mobility and a 2.13-points reduction on depression of the traditional groups respectively. Compared to the traditional CST group, there were no significant differences noted regarding cognition and memory recall. Incorporating spirtiuality and other faith-based themes in groups may provide additional benefit for individuals with memory loss. Both healthcare and long-term care facilities may benefit from incorporating group interventions such as CST into their routine care with older adults.

IMPLEMENTING VISUAL VIDEOS AND IMAGES WITH PEOPLE WITH DEMENTIA IN CARE SETTINGS: A SCOPING REVIEW
Karen Lok Yi Wong, 1 Mario Bayani, 2 Jim Mann, 2 Annette Berndt, 2 Lily Wong, 2 Carly Wang, 1 Diane Pan, 1 and Lillian Hung 1 , 1. University of British Columbia,Vancouver,British Columbia,Canada,2. Community Engagement Advisory Network,Vancouver,British Columbia,Canada There is limited literature on using visual videos and images with people with dementia in care settings. We conducted a scoping review on this topic to fill this literature gap. Our scoping review adopted the Joanna Briggs Institute scoping review methodology. We eventually included eleven papers for the review and conducted the content analysis. We found the facilitators for implementing visual videos and images with people with dementia in care settings: 1. Matching people's interests 2. Being congruent with people's cognitive abilities 3. Support from families and staff 4. Using in a group setting. We also found the barriers: 1. Staff is unwilling to support 2. Lack of resources 3. Not congruent with the cognitive or other abilities of the people. We found benefits of using visual videos and images with this population: 1. Encourage expression 2. Facilitate discussions with other people 3. Improve well-being. We also found drawbacks: the potential of arousing negative emotions and memories. We suggest future research should include the voices of people with dementia, staff should be trained to support the people in case negative memories and emotions are aroused, and there should be consideration of using visual videos and images to tackle isolation and loneliness in care settings. With these findings, this scoping review should shed light on implementing visual videos and images in care settings. People living with dementia and older adults who identify as sexual and gender minority (SGM -lesbian, gay, bisexual, transgender, queer individuals) both represent minoritized groups of older adults, but little is known about the health experiences of older adults who are at the intersection of having dementia and also identify as SGM. This review explored the extent and nature of research focused on health and healthcare experiences of SGM people with dementia and/or their informal caregivers. A scoping review framework was used given the exploratory nature of the project's purpose. Health librarians comprehensively searched four databases (MEDLINE, CINAHL, PsycINFO, AgeLine) to identify relevant studies. A total of 8,137 unique titles and abstracts were reviewed by 2 independent reviewers. Forty citations were determined relevant and reviewed by full text. Eight studies met inclusion criteria and were analyzed thematically. Study methods were quantitative cross-sectional (n=2), qualitative exploratory (n=4), and a mixed methods case study (n=1). Studies were published from 2010-2022. Sample sizes ranged from 1 to 415 (M=113, SD=116). Four studies focused on caregivers, 2 on persons with dementia, and 1 on dyads. Themes emerged pertaining to caregiver health and well-being, identity, relationships, disclosure, discrimination, and safety. Findings highlight the significance of inclusive care that addresses intersecting psychosocial and Innovation in Aging, 2022, Vol. 6, No. S1 health-related identities (e.g., cognitive status, SGM status, race/ethnicity, substance abuse history, multimorbidity) and that protects the rights of families of choice. More research is needed to better understand how sociopolitical structure influences dynamics between cognitive health and SGM status among older adults. Mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia are characterized by cognitive impairment and in AD a progressive functional impairment. This study sought to understand the role of geriatricians in treating patients with MCI/mild AD dementia. An anonymous, online survey was conducted in the US with 301 healthcare professionals (HCPs), including 75 primary care providers who practice as board certified geriatricians, and treat ≥10 patients per month with MCI/mild AD dementia. Geriatricians reported that among their patients with MCI/mild AD dementia, they initially make this diagnosis 70% of the time. Geriatricians reported that the topics commonly discussed with patients at the time of diagnosis are treatment options (85%), care management strategies (81%) and disease progression (80%). When referring patients to other specialties for treatment, geriatricians most often referred to neurologists (41%). Most (83%) geriatricians considered themselves the coordinator of care for patients with MCI/mild AD dementia; however, only 5% of non-geriatrician HCP respondents view geriatricians as such. Geriatricians reported prescribing/recommending treatments for ongoing management of MCI/mild AD dementia, with the most common being mental exercises (76%), acetylcholinesterase inhibitors (75%), social interaction (73%), medications to manage comorbidities (72%), and lifestyle improvements (72%). Most (76%) geriatricians have received advanced formal training in MCI/mild AD dementia care with the majority (84%) expressing that they feel very confident in managing patients with MCI/mild AD dementia. Geriatricians are specialists that are well trained and confident in diagnosing, treating, and managing patients with MCI/mild AD dementia.

GAIT AND/OR BALANCE DISTURBANCES AND THE ONSET OF ALZHEIMER'S DISEASE IN MILD COGNITIVE IMPAIRMENT Sangwoo Ahn, University of Tennessee at Knoxville, Knoxville, Tennessee, United States
Physical frailty is one of the fundamental hallmarks of aging. Older adults with mild cognitive impairment (MCI) are more likely to exhibit some characteristics of physical frailty such as worse gait and/or balance. Gait and/or balance disturbances may precede cognitive decline among cognitively healthy older adults. The purpose of this longitudinal observational study was to identify the temporal relationship between gait and/or balance disturbances and the onset of Alzheimer's disease (AD) because it has not been well characterized among older adults with MCI. Data of 2,692 older adults with MCI (ages 74.5 ± 7.1 years, women making up 47% of the sample) were from the National Alzheimer's Coordinating Center's Uniform Data Set. Risk of incident AD by baseline gait and/or balance disturbances was examined by Cox regression models over 4.0 ± 3.0 years, adjusting for demographic characteristics, medical conditions, and study site where the data were collected. The presence of gait and/or balance disturbances predicted 38% to 55% (hazard ratios [HR] 1.38 to 1.55) increased risk of AD. Findings remained robust in sub-group analyses by sex and there were no noticeable changes compared with the original analyses. Thus, regardless of sex, gait and/or balance disturbances predicted the onset of AD among older adults with MCI. Health care providers may need to (1) catch a warning of possible cognitive decline by a frequent assessment of gait and/or balance disturbances and (2) provide effective strategies to improve gait and/or balance disturbances to potentially delay the onset of AD.

EXPLORATION OF CARE CONTENTS AFFECTING STRESS VARIABILITY IN FAMILY CAREGIVERS OF OLDER PEOPLE WITH DEMENTIA
Sonoko Kabaya, Chieko Greiner, Masahide Nakamura, Yuko Yamaguchi, and Zhang Xuanrong, Kobe University, Kobe City, Hyogo, Japan Support for family caregivers (FCs) caring for older people with dementia in the home settings is a common issue in developed countries. Previous studies have reported that the increase in the burden of FCs not only causes health problems, but also makes it difficult to continue care at home and causes serious problems such as abuse. However, it is not clear how FCs' stress, which leads to increased burden, fluctuates within a day through daily care activities. The aim of this study was to explore care activities that influence the increase in FCs' stress. We recruited one dyad of an older adult with dementia over the age of 65 and a FC. Data collection was performed for consecutive 7 days throughout 24 hours. We adopted hamon® developed by Mitsufuji Corp. Japan to measure Heart Rate Variability (HRV)-based stress. Moreover, we asked a FC to talk with Virtual Agent on a laptop freely to understand when and what kind of care activities were done and how FC's feelings were. Kruskal-Wallis's test and Bonferroni's multiple comparison test were used to compare differences in stress in the care contents. Results showed that sleeping care, which is composed of such as assistance in using the toilet and changing clothes, gives more stress to FC, compared with morning care which includes such as assistance in changing clothes, eating breakfast, and taking medicine (p=0.042). this finding is beneficial for considering how to reduce FC's stress on daily care activities.